Month: January 2018

Buying anti-aging creams and serums has become a complicated process today due to the variety available and their misuse. By misuse, I am referring to how they are made. For example, did you know that antioxidants perform better when used with retinoids and sunscreens? Is buying anti-aging creams is confusing for you? If so, my purpose is to explain some of the terms used in articles about the skin and clear up some of that confusion you might have about using products.

Antioxidants comprise one of the two main categories of product additives which include the following:

Vitamin B3

Vitamin C

Vitamin E

Polyphenols/Flavonoids

As a group, antioxidants decrease the deterioration of collagen and reduce free radicals.

Retinoids better known as vitamin A or retinol are part of the second group called cell regulators. Products from either group can produce results in skin appearance, but work much better when used together with a sunscreen.

Antioxidants

Vitamin B3

Vitamin B3 is known for its ability to regenerate cells and maintain cell metabolism. It has also been shown to increase the elastin in the skin, reduce redness, and aid in removing or diminishing discolorations. In another study, a concentration of 5% niacinamide was applied to half the face of 50 women with additional results of improving wrinkles, fine lines, yellowing and hyperpigmentation (darker patches of skin). Examples of natural food sources of B3 are chicken and turkey breasts, tuna, and liver.

Vitamin C

You don’t hear much about Vitamin C being used for the skin, yet a number of research studies have confirmed that it is an important anti-aging product. Vitamin C has many benefits including its use after surgery to heal wounds and build scar tissue. It also strengthens cartilage, teeth, and bones. Oral Vitamin C is also used as a matter of routine by women who are aging because their bodies do not process it as well. Another important aspect of Vitamin C is that it is safe to use with other anti-aging agents including sunscreens, alpha hydroxy acids, Vitamin E and retinol.

Vitamin C’s ability to produce collagen is one reason for its incorporation in a number of anti-aging creams together with other ingredients shown to be effective in improving the skin’s appearance. As we age, collagen production goes down. Skin products are only as good as the percentages of the ingredients needed to produce good effects. You want to achieve at least 5% of Vitamin C.

When you review products for Vitamin C you should realize that not all of these products are effective because they do not reach through the skin as needed, nor do they transform the necessary components of Vitamin C into the skin. Those agents you most likely will find in an ingredient’s statement for Vitamin C are magnesium ascorbyl phosphate (MAP), which prevents water and collagen loss, and ascorbyl 6 palmitate, which destroys free radicals, and ascorbyl phosphate, which aids in the transport of agents through the skin.

Vitamin E

Vitamin E is an important additive to skin creams and serums. It acts as an anti-inflammatory and combats the proliferation of free radicals which cause skin damage. This vitamin has not been widely studied for its application to anti-aging products; however, it is well known to encourage wound healing. When applied to the outer layer of the skin, it enhances moisture retention and smooths the skin. Vitamin E is not as effective as Vitamins C or B3 and works best when used with Vitamin C. It is extracted from tomatoes, avocados, other fruits and vegetables, and some grains. Please see my Review section for a product that contains both vitamins C and E along with Ferulic Acid.

Polyphenols

Polyphenols are derived largely from fruits such as pomegranates, grapes, and kiwi, vegetables, grains, green tea, coffee and red wine. Products utilizing this antioxidant source are harder to find. While it has been around for quite a while as an anti-aging agent, one of the polyphenols, ferulic acid, has become more popular when used in combination with vitamins C and E. Ferulic acid is extracted from the membranes of oranges, rice, peanuts, wheat and other foods. If was found by Duke University to act as a sunscreen and to prevent wrinkles.

Cell Regulators

Vitamin A

Cell regulators include Vitamin A derivatives, polypeptides, and botanicals that work on the metabolism of cells and induce the production of elastin and collagen. The primary vitamin A version we will discuss here is one used in over-the-counter anti-aging creams and serums–retinol. The more potent form of retinol, tretinoin, can cause severe skin irritation and is used by dermatologists. If you are considering seeing a dermatologist, using an over-the-counter product with retinol is recommended beforehand, as that will give you the opportunity to test it on your skin.

Vitamin A in the form of topical retinol used at .04% was effective in a study done with senior citizens and was found to increase collagen and moisture in the skin after a 24-week trial. They concluded that topical retinol was effective in improving wrinkles through increasing collagen production and water retention in the skin. Interestingly, they also found that skin treated with retinol was “more likely to withstand skin injury and ulcer formation.”

Polypeptides

In a study reported by NIH the number, length, and depth of wrinkles was markedly improved by the application of a gel with 3% collagen-like hexapeptide and 1% booster molecule twice a day for four weeks.

Peptides are gaining in popularity and can be identified in the ingredients statements under several names:

Peptides come from broken strands of collagen called amino acids—the active molecules and small proteins.

Summary

Yes, shopping for skin care products is very confusing. An important thing to know is that you should look at the ingredients statements for items that represent those I have discussed. While it does not generally tell you how much of an agent is included, it does list them in descending order of strength. If the agents you are looking for are at the end of a long list, move on to another product. You want them closer to the middle. Sometimes, the actual percentages are shown near the item name. If there is anything you would like to add to my post or say about it, please use the Comments section below for that. I am open to suggestions and discussion.

Please enjoy this youtube video to learn some more tips from one of the best in the dermatology field:

Why would anyone want to improve an already good thing? The most obvious answer is that there is always room for improvement. Yes, you have heard it many times. Truth is that while we think we reveal positive self-images, other people don’t always see us as we see ourselves. Sometimes, we believe we have attributes that we really don’t have, and we believe it so sincerely, there is no telling us otherwise. That alone is a good reason for assessing ourselves and trying to determine how we come across to others; however, there are other reasons. So, what does it take to feel good about yourself: your self-image?

Woman must not accept; she must challenge. She must not be awed by that which has been built up around her; she must reverence that woman in her which struggles for expression.

Margaret Sanger

Why Would We Want to Change?

Jennifer Crittenden has written a wonderful book, You, Not I: Exceptional Presence, where she defines presence as “the ability to manage the perceptions of others through our observable behaviors.” Further, she notes that changing our behaviors to display credibility, authenticity, and trust is extremely important in demonstrating our “potential to get noticed, be promoted, and improve your financial compensation.”

Other reasons for wanting to change would include wanting to feel that we are accepted in a group, wanting to reach that stage of authenticity where we no longer worry about how we look to others, and wanting to feel comfortable in any environment with the ability to demonstrate that “I am in control of my life.” .

Barton Goldsmith emphasizes a number of helpful ideas about making the changes necessary to possess and portray a more positive self-image. One of my favorites is to refuse to get insulted. Dr. Goldsmith says that you need to consider where the supposed insult came from and ignore the issue if you decide its origin lies with that individual. Don’t react. If that person thinks he has a legitimate reason for insulting you, he has a responsibility to share that with you.

“The most courageous act is still to think for yourself. Aloud.” ― Coco Chanel

When you look at these, you realize that there are many things that might possibly fit into the change category for you. You want to look at them as changes that would help you to feel better about yourself. Some of them likely have been gnawing at you. You will also come up with some items not listed. Sometimes we allow those missing items to hold us back. So ask yourself, “What is my problem?”

Generally, all of those things that you have accomplished contribute to your overall self-assessment and without even telling people about your background, you can radiate success through your attitude, behaviors, and personality. Not surprisingly, feeling better about yourself leads to an improved aura. You obviously feel more comfortable and people notice that. They enjoy being around you more.

If you are retired, occupation is not a concern, but staying busy and productive in areas like volunteering, mentoring, and just belonging to a group can be very stimulating. Body image may not be a concern during the latter stages of your life, except for the health angle. You might also say, “why worry about skills?” Skills keep your mind going. The theme of this website is all about successful aging, and improvement in any area certainly contributes to further personal growth and extended life.

Knowledge of other people’s beliefs and ways of thinking must be used to build bridges, not to create conflicts. Kjell Magne Bondevik

www.brainyquote.com

The bridge for an improved self-image is going down–simply put, it is not an uphill challenge to effect change.

How to Work on Change

You might find it helpful to keep a journal of your activities. Make a list of all of the things you know you do well. Then make a list of those things you want to change about yourself, setting realistic goals for getting to where you want to be. Record your successes and your final achievement of each goal, stating what you did and why it was important to you. Mountain State Centers for Independent Living has a website to further assist you in this endeavor.

1. Do not exaggerate. This is something most of us are prone to do because we think it sounds good to others. Deep down we feel guilty because we know we misrepresented the truth.

2. Maintain a positive attitude. This can be difficult, especially if you have come through a life of having negative events. Remember that you are past these now and that you have gotten what is important from them to help you.

3. Understand that none of us is perfect and be willing to be honest with people when you make a mistake. Often, an apology will do.

4. Don’t stay awake at night beating yourself up because you might have done the wrong thing.

5. Refuse to feel bad about things you have no control over.

6. When you recognize a fault you want to repair, practice the right things to do and encourage yourself. Google it and see what others are doing about it. Work with a friend and ask them to take note of those changes as they occur. Believe in yourself and your ability to execute change.

If you want to get deeper into improving your self-image try the Cleveland Clinic.

Summary

Very often we do not think about improving the way we think about ourselves and how others view us until we get caught in a situation where our performance is important. Whether we want to get what we believe we are entitled to or just put off a persistent salesperson, we need to feel and look confident. It could be buying a house or car, speaking in front of a homeowners’ association, or advocating for change for something we feel passionate about in the community. We want to be able to do our best.

Importance of Volunteer Caregivers—Financially

Based on a recent article in WebMD, caregivers are saving the U.S. Government–that is, you, the taxpayers–a whopping $470 billion a year. Caregivers come from all areas, but the most astonishing source is from children, ages 8-18, many of whom have had to quit school. This group represents 22% of volunteer caregivers. Forty percent are men, and 33 percent are women. (The Invisible Workforce, by Lisa Marshall) Helping caregivers that help aging seniors aging in place and other sick individuals to stay with their loved ones is very important.

That $470 billion is an amazing figure that gives rise to the thought of what the government is doing with this huge savings. To further give you an idea of how large this saving is, the National Respite Coalition reports that in 2009, the estimated value of 42.1 million caregivers for adults was $450 billion a year and that this figure was more than Medicaid spent in 2009. Adding four to eight million more caregivers for children increased the total saved the taxpayers an additional $50 to 100 billion. When we think of caregivers, we think of seniors getting too old to take care of themselves. We don’t realize the large number of people in this country with diseases from the following categories that require care. Please note that this list does not include all forms of cancer nor does it include severe mental illnesses other than depression:

Amyotrophic Lateral Sclerosis (ALS)

Alzheimer’s Disease

Brain Tumor

Dementia

Dementia with Lewy Bodies

Depression

Frontotemporal Dementia

HIV-associated Neurocognitive Dementia (HAND)

Huntington’s

Hypoxic-Anoxic Brain Injury

Mild Cognitive Impairment (MCI)

Parkinson’s Disease

Traumatic Brain Injury

Stroke

Vision Loss & Blindness

Wernicke-Korsakoff Syndrome

This list of illnesses comes from Family Caregiver Alliance, the oldest organization in this country for caregivers. Their statistics show that 80% of people diagnosed with these illnesses are cared for by their family members. But back to that $470 billion. It would behoove us to insist that that amount of money be set aside for health issues and anything related to caring for the sick and the elderly. This might mean our foreign aid would be reduced, but we have really been fighting that issue for a long time, haven’t we?

Caregivers – Family Member or Paid Employee

Family Members

According to Joseph Matthews, an attorney with caring.com, assistance is available in some states for paying a low-income client or in some cases one where there is “slightly too much income or assets to qualify for Medicaid” the same amount of money that would be paid for help through a certified home care agency. The recipient can use this money to pay his caregiver, whether it be a spouse or a child. Children who are considering reducing their hours or quitting their jobs should consult the site further for information on how they might be paid for providing their help to a parent. See if your state has a Cash and Counseling program by contacting the Medicaid office in your area. Mr. Matthews has written two books on this subject for those who are trying to make plans for long-term care. One of those is Long-Term Care: How to Plan & Pay for it: This book is available from Amazon.com and is shown below for ordering from them. Those who have rated it did so with five stars!

Paid Caregivers

Every time I see an article about caregiving, I want to cry, regretting that I did not take care of my mother. Others told me that she needed 24/7 care, but I believe she could have been kept in her own home with just me there. Not that I am special, but I had training in caring for older and dying people that would have facilitated my taking care of her. I also believe that she would have lived a lot longer and with happier days. I was too easily swayed to go along with the prevailing opinions, but if I had to do it over again, I would seek help on how I might adequately care for my mother and save myself at the same time.

The decision to place her in a nursing home came too soon after her confinement for rehabilitation following repair of a broken hip. The rehab staff made the decision within 24 hours of her admission. She actually appeared to have no hope and no desire to do anything to get better after that decision. She had been given a drug to calm her that actually caused her to act inappropriately. This changed when the medication was changed.

If this happens to you, try to discuss it with family members properly, pointing out that you, too, have a stake in your loved one’s care, that you have a voice, and that all family members should be satisfied that they are doing the right thing:

Postpone the decision to put someone in a nursing home with all members acting together to provide temporary or better permanent care.

They need to assure themselves that they are in agreement.

They need to be interested in learning about other avenues of care.

Each person should question their own motive which sometimes includes thinking they know best, not wanting to take responsibility for their loved one, not wanting to be outdone by a family member who might be willing to make the sacrifice to care for the loved one, or wanting to exert power over another.

Erroneous thoughts need to be disproved with second opinions.

My mother had been doing what she loved best—caring for her flowers outdoors when she fell backward onto a concrete stepping stone. Forty-four million people are taking care of their loved ones in their own home. That is 13.6% of our current population. I have come to believe it is the single most important thing we can do for our loved ones whenever it is possible. Why do I say that?

According to the National Center on Elder Abuse, abuse is admittedly occurring in nursing homes and in assisted living facilities on a large scale. Please review the two-page report on the types of abuse, particularly the pie charts which show very little variation between nursing homes and assisted living facilities, except in financial exploitation and resident-to-resident abuse, where the latter is higher and the resident abuse is lower in the assisted living facilities, as you might guess. Also, please see the best and most extensive article I could find on elder abuse, especially for the list of how seniors or residents are mistreated. These are things we just don’t think about, such as changing soiled underwear or brushing their teeth.

I was recently confined for physical therapy following back surgery. I arrived there on a Friday afternoon and by Saturday afternoon, I was ready to leave. On Monday at 8 am, I called my doctor’s office, begging them to have me discharged. My doctor contacted the doctor in the facility who visited me and assured me that I should be ready for discharge by Wednesday. I needed more physical therapy. He also assured me that he would write some orders that should improve the care I had been getting. The revised orders did little to improve the delivery of pain medication, but the physical therapy was a pleasure to look forward to. That is the only thing that got me through that five days. Sure enough, the doctor arrived early Wednesday afternoon, and I was gone within 30 minutes. This occurred after the director of the rehabilitation area informed me the day before that because she had not received 48 hours notice, I would not be leaving. Three of many of my observations were:

1. The food was awful. The watery consistency of cream of wheat and grits with no seasoning is a prime example of what was available. My diet was a regular one. The best meal was the last meal, which I am sure surfaced as a result of a visit by the dietitian the day before.

2. Staff would make excuses for not doing their jobs. Unfortunately, they worked 12-hour shifts, and you could find them sleeping in the middle of the night in the lobby and dining area. They worked harder at covering for each other when one was not to be seen anywhere.

3. During my last night there, my roommate told the nurse that her pacemaker was shocking her. While the nurse acknowledged hearing this, she did nothing about it. About 7:45 am–before breakfast–an occupational therapist came to get me for therapy. It was a short day for him and he wanted to get it over with. Fortunately, he noticed my roommate shaking uncontrollably. Our beds were separated by a curtain. He called the staff, my roommate lost consciousness, use of the crash cart was required, a doctor arrived on the scene, and my roommate was transported to the hospital next door. No one could give me any information on how she fared.

Six weeks after my discharge, I received a survey for completion about the rehab/nursing home from an independent source. I completed it with pleasure. You might say that my encounter was an isolated incident, but it was not. I talked to friends who had relatives there with the same or similar stories and I read the nursing home reviews on the Internet. People might also say, “What do you expect, you are getting free care?” Wrong. I have paid the deduction for Medicare since its inception. Along with the rest of you on Medicare, I pay the newly increased amount of $134.00 per month for Part B of Medicare that includes considerable deductions, depending on which Medicare advantage plan you select.

Research Regarding Mistreatment in Nursing Homes and Assisted Living

It must be difficult to generate studies that prove what I am saying, except maybe by surveys, but I believe more are necessary. Those that have been done are not being acted on quickly enough. Medicare needs to improve the way their approved institutions take care of their residents. Employers need the funds to provide employees with proper training, and the training should be enforced in the work environment. Yes, this enforcement would cost extra money to have someone available for each shift to properly supervise, halt improper activities, and report what employees are doing if they fail to follow through on their instructions. Additionally, I believe cameras should be utilized in each area where staff and residents see each other.

The government needs to find out what makes paid caretakers tick. Why do they abuse their patients and residents? In many areas, they are actually demanding $15 an hour to care for people, while many with college educations don’t make that. Home health agencies benefit the most from sending out paid volunteers who very often make their own rules that sometimes amount to fraud. Stricter laws need to be enacted for those who mistreat the sick or those at the end of their life. Sick people are hardly able to fight back, and many would rather die than to have to be in an institution where they get the care they do not deserve.

What Should Medicare do with the Billions saved by Caregivers?

Capture the gain and spend it to improve the training and care of volunteer caregivers, not to mention provide them stipends. Most of them have given up a job or school, reduced their retirement benefits, lost their hospitalization, and lost a significant part of their own life to care for a loved one. As Lisa Marshall[1] points out, some government entities have begun counseling for individuals and families of caregivers, support groups, and other services, but this is not available in all states. Caregivers increase their chances of acquiring dementia after taking care of spouses with the same illness. They also acquire more heart disease, depression, and anxiety than non-caregivers. This will eventually cost them and the government additional funds.

With the number of possible caregivers declining for family members due to declining family size, more are going to be forced to go to institutions, where they are not going to get good care. The attitudes toward older people and those with serious illnesses should be changed. Rather than being looked at as individuals destined to die at any moment, they should be revered as people who have earned the right to die as peacefully as possible and with dignity.

Summary

If you are thinking about becoming a caregiver, please review the caregiver training available for those uncomfortable about taking care of a loved one or those thinking about becoming a CNA. This training is provided on site in schools and colleges and online through schools, organizations, and YouTube videos. One example of a YouTube video is this one of a series taught by Family Caregiver Alliance.

I encourage you to come up with your own ideas and either post them in the comments section below, forward them to your congressmen and women, join nonprofit organizations to advocate for the sick, elderly, and caregivers, or all of the above. See below for another excerpt from an important series of taking care of those with dementia.